BOSTON – Although classically used to prevent infection, antibodies could play a role in the long-term viral suppression of HIV, and could target and kill infected cells, according to a speaker at CROI 2016.

John R. Mascola, MD, of the National Institutes of Allergy and Infectious Disease’s Vaccine Research Center, in Bethesda, Maryland, addressed a packed auditorium at the the CROI 2016 meeting this week, and noted that antibodies against HIV continue to be discovered or engineered, and hold strong promise for patients with HIV.1

Dr Mascola noted that antibodies for HIV-1 could have a role in treating patients with HIV, as they have a distinct mechanism of action from antiretrovirals, and show the potential to eliminate infected cells, as well as provide long-term therapeutic effects.


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He noted recently-published data that concluded: “a single infusion of HIV-1–neutralizing monoclonal antibodies VRC01 significantly decreased plasma viremia and preferentially suppressed neutralization-sensitive virus strains.”2

Most of the published literature on the monocolonal antibodies (mAbs)  show similar patterns, Dr Mascola explained, specifically, “you can get full viral suppression if the viral load starts low, but there is rapid selection for resistance virus. There are also some cases where the individual doesn’t respond at all. Those individuals generally start off with resistance.”

Since resistance can occur rapidly in the setting of incomplete viral suppression, perhaps combinations of mAbs and antiretrovirals will likely be needed in these patients, Dr Mascola said.

“Clinical data are needed to stimulate future development of antibodies for prevention and treatment,” Dr Mascola concluded.

Joseph J. Eron Jr, MD, of the University of North Carolina at Chapel Hill, North Carolina who spoke during the same plenary session as Dr Mascola, agreed that more data are needed and noted that combinations of antibodies with different targets will be needed for them to be effected. He added that “we really need to cover all viruses … to be successful.”

References

1. Mascola JR. Harnessing Antibodies for HIV-1 Prevention and Treatment. Presented at: CROI 2016; February 22-25, 2016; Boston, MA.

2. Lynch RM, Boritz E, Coates EE, et al. Virologic effects of broadly neutralizing antibody VRC01 administration during chronic HIV-1 infection. Sci Transl Med. 2015;7(319):206.